2026-01-01 COI GL PL.pdf

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Attached to
Master Agreement AZ|CTR076390
Contract number
CTR076390
Issued by
Arizona

About this file

This document is an ACORD Certificate of Liability Insurance for Mayo Collaborative Services, Inc. (doing business as Mayo Clinic Laboratories), issued on February 13, 2025. The certificate names the Arizona Department of Health Services in Phoenix, AZ as the certificate holder, with coverage provided by Mayo Insurance Company Limited.

The insurance certificate covers professional liability with policy limits of $2,000,000 per claim and $4,000,000 aggregate, effective from January 1, 2025 to January 1, 2026. The policy includes the State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, and employees as additional insureds with respect to liability arising from activities performed by or on behalf of the insured. The policy also includes commercial general liability coverage with a $1,000,000 each occurrence limit and various standard aggregate limits.

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CTR075690_Pricing.xlsx XLSX spreadsheet
2026-01-01 COI WC.pdf PDF
CTR075690_Contract_Documents.pdf PDF
CTR076390_Amendment_One__1__fully_executed.pdf PDF

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Text version

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE

INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #

NAME:

CONTACT

(A/C, No):

FAX

E-MAIL

ADDRESS:

PRODUCER

(A/C, No, Ext):

PHONE

INSURED

REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED

REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

OTHER:

(Per accident)

(Ea accident)

N / A

SUBR

WVD

ADDL

INSD

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

$PROPERTY DAMAGE

BODILY INJURY (Per accident)

BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY

Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH)

DESCRIPTION OF OPERATIONS below If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE

E.L. DISEASE - POLICY LIMIT

E.L. DISEASE - EA EMPLOYEE

E.L. EACH ACCIDENT

ER

OTH-

STATUTE

PER

LIMITS(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR

INSR

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

EXCESS LIAB

UMBRELLA LIAB $EACH OCCURRENCE

$AGGREGATE

OCCUR

CLAIMS-MADE

DED RETENTION $

$PRODUCTS - COMP/OP AGG

$GENERAL AGGREGATE

$PERSONAL & ADV INJURY

$MED EXP (Any one person)

$EACH OCCURRENCE

DAMAGE TO RENTED

$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY

PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03)

© 1988-2016 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

1,000,000

272-1-05011/25

HOU-004170141-01

X

AGGREGATE

N

01/01/2025

TSDatabase@Mayo.edu

PROFESSIONAL LIABILITY

2,000,000

1,000,000

A

02/13/2025

4,000,000

01/01/2025

2,000,000

The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, and employees as additional insureds with respect to liability arising out of the activities performed by or on behalf of the Insured.

X

Phoenix, AZ 85007

Arizona Department of Health Services

A

3733-MICL-Main-25-26

EACH CLAIM

1,000,000

50,000

01/01/2026

BY INSURED"

"COVERAGE INDEPENDENTLY PROCURED

d/b/a Mayo Clinic Laboratories

Mayo Collaborative Services, Inc.

272-1-05011/25

150 N. 18th Avenue, Suite 530

X

Certificate Requests

01/01/2026

Mayo Insurance Company Limited

Parker, Alfie Marsh V

File details come from the government source that posted it. Updated .